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Why Health Care IT Is Still on Life Support

Experts ask: ‘What’s in it for doctors?’

Six years ago, the Obama administration launched the Health Information Technology for Economic and Clinical Health (HITECH) Act, a $30 billion program to put electronic health records (EHRs) in every hospital and doctor's office. The Act offered incentives for doctors who bought and “meaningfully used” the new technology, and penalties for those who failed to adopt thetechnology quickly enough. The goal was to get doctors to store patient data and to share it electronically with the patients, other physicians, public health agencies, laboratories, and other players in the health care enterprise.

There was just one problem: Medicine may have been in need of a high-tech revolution, but the Obama administration may not have thought hard enough about whether the technology was ready for medicine, according to an article posted on the Politico website.

When President Obama took office, most doctors still kept their patients’ records on paper. Only 17% relied on EHRs. Now, doctors spend many of their working hours in front of a computer screen, and they aren’t happy about it, the article says.

In 2008, author Clayton Christensen predicted in his book The Innovator’s Prescription that the key obstacle to data sharing would be the lack of a profit motive for doctors. It was foolish to expect physicians to invest in electronic records systems that “make it easier for other caregivers to care more effectively for their patients,” he wrote. “While providers are expected to bear the cost of implementing an [electronic records system], most of the benefits — such as improved patient safety, data security, care coordination and disease prevention — accrue to patients, insurers and payers but not to the providers.”

According to Politico, physician surveys have identified EHRs as the biggest cause of job burnout — worse than long hours, billing, and other nuisances. One frequent complaint is mental strain. In the computer, the doctor’s notes go from being a narrative of the patient’s condition to a series of checkboxes. Each visit reads much like the last because the computer software requires exhaustive information with the objective of satisfying billing needs.

Further, EHRs are usually listed among the top 10 safety concerns for doctors because they introduce new kinds of errors, Politico says. A disturbing example was outlined in a book by Dr. Robert Wachter of the University of California, San Francisco: a sick boy at Wachter’s hospital received a 40-fold overdose of a powerful antibiotic because of the mistaken belief that the computer was measuring the dosage by weight.

Despite the new dangers, many EHR vendors’ contracts contain a “hold harmless” clause that protects them from legal responsibility for errors to which their software may contribute, according to the Politico article.

Source: Politico; June 11, 2015.

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